Individual provider Active NPI

Stuart O Rosenberg, MD

  • Nephrology Physician
  • Bronx, NY
National Provider Identifier
1356426126
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
169857 Issued in NY
Practice address
Montefiore Medical Park
1575 Blondell Avenue, Ste. 220
Bronx, NY 10461
Phone
(866) 633-8255
NPI assigned
Oct 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 169857 NY Primary

Addresses

Primary practice location

Montefiore Medical Park
1575 Blondell Avenue, Ste. 220
Bronx, NY 10461

Mailing address

355 Winthrop Rd
Teaneck, NJ 07666-3020
Phone (866) 633-8255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050228000706 NY Practitioner - Nephrology 1850344011 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
169857NYMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center Nephrology CurrentSince Jan 1, 2006 Accepting new patients
Montefiore Medical Center CurrentSince Jan 1, 2006 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

111 E 210th St
#9
Bronx, NY 10467
Phone (718) 920-5442

1250 Waters Pl
Bronx, NY 10461
Phone (718) 409-9444

1575 Blondell Ave
Ste 200
Bronx, NY 10461
Phone (718) 405-8260

1575 Blondell Ave
Ste 220
Bronx, NY 10461
Phone (718) 405-8019

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356426126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 WINTHROP RD",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076663020",
            "telephone_number": "866-633-8255",
            "fax_number": "718-405-8278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MONTEFIORE MEDICAL PARK",
            "address_2": "1575 BLONDELL AVENUE, STE. 220",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10461",
            "telephone_number": "866-633-8255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "STUART",
        "middle_name": "O",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "169857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.